Intra-operative management of low portal vein flow in pediatric living donor liver transplantation

Ting Lung Lin, Li Wei Chiang, Chao Long Chen, Shih Hor Wang, Chih Che Lin, Yueh Wei Liu, Chee Chien Yong, Tsan Shiun Lin, Wei Feng Li, Bruno Jawan, Yu Fan Cheng, Tai Yi Chen, Allan M. Concejero, Chih Chi Wang*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

For pediatric living donor liver transplantation, portal vein complications cause significant morbidity and graft failure. Routine intra-operative Doppler ultrasound is performed after graft reperfusion to evaluate the flow of portal vein. This retrospective study reviewed 65 children who had undergone living donor liver transplantation. Seven patients were detected with suboptimal portal vein flow velocity following vascular reconstruction and abdominal closure. They underwent immediate on-table interventions to improve the portal vein flow. Both surgical and endovascular modalities were employed, namely, graft re-positioning, collateral shunt ligation, thrombectomy, revision of anastomosis, inferior mesenteric vein cannulation, and endovascular stenting. The ultrasonographic follow-up assessment for all seven patients demonstrated patent portal vein and satisfactory flow. We reviewed our experience on the different modalities and proposed an approach for our future intra-operative management to improve portal vein flow at the time of liver transplantation.

Original languageEnglish
Pages (from-to)586-591
Number of pages6
JournalTransplant International
Volume25
Issue number5
DOIs
StatePublished - 05 2012

Keywords

  • inferior mesenteric vein cannulation
  • living donor liver transplantation
  • portal vein complication
  • stent

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